交泰疏肝汤辅助治疗肝气郁结型2型糖尿病合并抑郁症的临床研究  

Clinical study of Jiaotai Shugan decoction in adjuvant treatment of type 2 diabetes mellitus complicated with depression with liver qi stagnation type

作　　者：刘永进 杜博 詹惠娟 刘晶 王燕 王安平 华英 谢美霞 LIU Yongjin;DU Bo;ZHAN Huijuan;LIU Jing;WANG Yan;WANG Anping;HUA Ying;XIE Meixia(Ward 15,the Second People’s Hospital of Lishui City,Lishui 323000,Zhejiang,China;Department of Science and Education,the Second People’s Hospital of Lishui City,Lishui 323000,Zhejiang,China)

机构地区：[1]丽水市第二人民医院十五病区,浙江丽水323000 [2]丽水市第二人民医院科教处,浙江丽水323000

出　　处：《中国现代医生》2024年第21期95-98,103,共5页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2022ZB410)。

摘　　要：目的探讨交泰疏肝汤辅助治疗肝气郁结型2型糖尿病(type 2 diabetes mellitus,T2DM)合并抑郁症的临床效果。方法选取2022年6月至2023年6月丽水市第二人民医院收治的肝气郁结型T2DM合并抑郁症患者90例,随机分为对照组和观察组,每组45例。两组患者均进行糖尿病基础治疗,对照组加用艾司西酞普兰片进行治疗,观察组在使用艾司西酞普兰片的同时加用交泰疏肝汤治疗。治疗8周后采用汉密顿抑郁量表-24(Hamilton depression scale-24,HAMD-24)评分和健康问卷抑郁量表-9(patient health questionnaire-9,PHQ-9)评分评估两组的临床疗效,测定两组患者的血清5-羟色胺(5-hydroxytrytamine,5-HT)、去甲肾上腺素(noradrenaline,NE)、脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)水平及空腹血糖(fasting blood glucose,FPG)、餐后2h血糖(2-hour postprandial blood glucose,2hPG)、糖化血红蛋白(haemoglobinA1c,HbA1c)水平,并记录不良反应。结果观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗8周后,观察组患者的HAMD-24及PHQ-9评分均低于对照组(P<0.01);5-HT、NE、BDNF水平均高于对照组(P<0.01);FPG、2hPG、HbA1c水平均低于对照组(P<0.01)。两组不良反应比较差异无统计学意义(P>0.05)。结论交泰疏肝汤加减治疗肝气郁结型T2DM合并抑郁症可改善患者HAMD-24评分及PHQ-9评分,提高5-HT、NE、BDNF水平,降低FPG、2hPG、HbA1c水平,临床疗效较好且无明显不良反应。Objective To investigate the clinical effect of Jiaotai Shugan decoction in adjuvant treatment of type 2 diabetes mellitus(T2DM)complicated with depression with liver qi stagnation type.Methods From June 2022 to June 2023,90 patients with T2DM complicated with depression with liver qi stagnation type treated in the Second People’s Hospital of Lishui City were selected,who were randomly divided into control group and observation group,with 45 cases in each group.Both groups were treated with basic treatment of diabetes,control group was given escitalopram to improve the emotion,while observation group was further given Jiaotai Shugan decoction.After 8 weeks,the clinical effective rate were evaluated by Hamilton depression scale-24(HAMD-24)and patient health questionnaire-9(PHQ-9)scores,the levels of 5-hydroxytrytamine(5-HT),noradrenaline(NE),brain-derived neurotrophic factor(BDNF),fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG)and haemoglobinA1c(HbA1c)were detected,and adverse reactions were recorded.Results The clinical total effective rates of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).8 weeks after treatment,HAMD-24 and PHQ-9 scores of observation group were lower than those of control group(P<0.01).The levels of 5-HT,NE and BDNF of observation group were higher than those of control group(P<0.01).The levels of FPG,2hPG and HbA1c in observation group were lower than those in control group(P<0.01);There was no significant difference in adverse reactions between two groups(P>0.05).Conclusion Modified Jiaotai Shugan decoction is effective in treating T2DM complicated with depression with liver qi stagnation type,can reduce HAMD-24 and PHQ-9 scores,increase the levels of 5-HT,NE,BDNF,and reduce the levels of FPG,2hPG,HbA1c.There was no obvious adverse reactions.

关 键 词：2型糖尿病 抑郁症 肝气郁结 艾司西酞普兰 交泰疏肝汤 

分 类 号：R256.4[医药卫生—中医内科学]